If you need cataract surgery, you may have the option of paying extra for new presbyopia-correcting IOLs
(intraocular lenses) that potentially can restore a full range of vision without eyeglasses.
Multifocal and accommodating IOLs may offer significant advantages
over conventional single-vision IOLs, which typically provide clarity at near, intermediate, or distance ranges — but not all three at once.
For example, a single-vision or monofocal IOL might enable you to read fine newspaper print. But you would still need
eyeglasses to drive.
Presbyopia-correcting IOLs are new in the marketplace, so you may have questions such as:
1. Why would I want a multifocal or accommodating IOL for cataract surgery?
The U.S. Food and Drug Administration approved certain presbyopia-correcting IOLs
only within the last few years. This means that, for the first time, people undergoing a cataract procedure have the chance to achieve independence from eyeglasses.
Remember, however, that for certain near vision activities you may still benefit from wearing eyeglasses, even if you do choose a multifocal or accommodating IOL.
2. But aren't presbyopia-correcting IOLs a lot more expensive? How much extra do I have to pay?
Presbyopia-correcting IOLs are more expensive because they cost more for companies to develop and produce, and
because extra surgeon skill is required for a procedure. Also, extra care must be taken with these lenses to make sure you
receive the exact right prescription for your eyes. Costs vary, depending on the lens used, but you can expect to pay up to
$2,500 extra per eye. Otherwise, basic costs of cataract surgery are covered by
Medicare and virtually all health insurance policies.
3. Why won't Medicare or health insurance cover the full cost of presbyopia-correcting IOLs?
A multifocal or accommodating IOL is
not considered medically necessary. In other words, Medicare or your insurance will pay only the cost of a basic intraocular lens
and accompanying cataract surgery. Use of a more expensive, presbyopia-correcting lens is considered an elective
refractive procedure, a type of luxury,
just as LASIK and PRK are refractive procedures
that also typically are not covered by health insurance.
4. Can my local cataract surgeon perform presbyopia-correcting surgery?
Yes, but you need to make sure that your eye surgeon has experience with the specific presbyopia-correcting IOL chosen for the procedure.
Studies have shown that surgeon experience is a key factor in successful outcomes, particularly in terms of whether you will need to wear
eyeglasses following cataract surgery.
5. What problems are associated with presbyopia-correcting IOLs?
At a 2007 American Society of Cataract and Refractive Surgery (ASCRS) conference in San Diego, some reports indicated that
even experienced cataract surgeons needed to perform enhancements for 13 percent to 15
percent of cases involving use of different
presbyopia-correcting IOLs. This means you and your surgeon must be prepared to undergo a few extra steps (if needed),
if you do want independence from eyeglasses. Enhancements don't mean that the procedure itself was a failure,
because you likely will see just fine with eyeglasses even if your outcome is less than optimal. But you may need
extra surgical procedures such as LASIK, or insertion of an additional IOL (piggyback lens) to perfect your
uncorrected vision. Depending on the arrangement you make with your eye surgeon, you also may need to pay
extra for any needed enhancements.
Cataracts
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